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Sofosbuvir Found to Be Safe, Effective in Patients with Chronic Kidney Disease

Part of the treatment regimen for individuals with chronic kidney disease (CKD) and hepatitis C virus (HCV) infection, direct-acting antiviral (DAA) medications may, in fact, provide greater benefit to infected individuals than previously thought. The results of a new study, published in the Clinical Journal of the American Society of Nephrology, show that DAAs may even help improve the kidney function of some patients.

“There has been very limited data regarding the safety of direct-acting antiviral therapies in patients with CKD,” corresponding author Meghan Sise, MD, MS and an assistant in medicine at Massachusetts General Hospital, said. “This study shows that kidney function was, on average, stable during DAA therapy.” 

HCV infection is common in patients with CKD and increases their risk of progressing to kidney failure, the researchers wrote. However, most HCV-infected patients with CKD remain untreated because of adverse effects from therapies such as interferon, ribavirin, and first-generation protease inhibitors.

The direct-acting antiviral sofosbuvir (Sovaldi, Gilead Sciences Inc.) has had a high success rate in treating chronic HCV. But the potential for toxicity to the kidneys has raised some concern, especially in patients with CKD, the researchers said.

Therefore, Dr. Sise and her colleagues at Massachusetts General Hospital set out to learn more. To this end, they studied 98 patients with stages 1-3 CKD who received sofosbuvir-based therapy in a large healthcare system. 

Overall, the investigators found that sustained virologic response (SVR) reached 81%, with patients maintaining stable kidney function. Interestingly, individuals with advanced CKD were more likely to be cured of HCV than those with mild cases. In addition, patients who reached SVR saw improved kidney function following treatment, the researchers found.

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